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Original Articles
Trends of accidental carbon monoxide poisoning in Korea, 1951-2018
Jong-Hun Kim, Ah-Young Lim, Hae-Kwan Cheong
Epidemiol Health. 2020;42:e2020062.   Published online August 31, 2020
DOI: https://doi.org/10.4178/epih.e2020062
  • 16,284 View
  • 223 Download
  • 7 Web of Science
  • 4 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Carbon monoxide (CO) poisoning from coal briquette combustion has been a major public health problem in Korea. In this study, we estimated the time trends of the consumption of anthracite coal and the number of CO poisoning victims over the past 7 decades, in the context of changes in heating facilities.
METHODS
Using Population and Housing Census data and energy statistics, we estimated the number of houses using briquettes as heating fuel between 1951 and 2018. After estimating the incidence of CO poisoning in housing units by heating facility type, we determined the ratio of the number of household members who experienced CO poisoning to the overall number of household members. Finally, we estimated the distribution of the victims according to poisoning severity, excluding victims of intentional exposure.
RESULTS
We estimated that, overall, over 26 million people experienced CO poisoning between 1951 and 2018 in Korea. The household consumption of anthracite peaked in 1986, but the number of victims of CO poisoning peaked at approximately 1 million people in 1980. From 1951 to 2018, the cumulative number of CO poisoning victims comprised approximately 22,830,000 mild cases, 3,570,000 severe cases, and 65,000 deaths.
CONCLUSIONS
The peak in the number of CO poisoning victims occurred 6 years earlier than the peak in the number of people using briquettes for heating. This gap resulted from improvements in briquette heating systems. This finding provides a quantitative basis for epidemiological studies on the health outcomes of CO poisoning in the Korean population.
Summary
Korean summary
과거에 연탄을 난방 연료로 사용함으로써 발생하였던 일산화탄소 중독 사고는 한국 사회에서 주요한 공중 보건 문제였다. 본 연구에서는 지난 70년간 연탄 소비에 따른 일산화탄소 중독 피해자 규모를 추정하였다. 본 연구에서 산출된 결과들은 일산화탄소 중독으로 인하여 지속적으로 나타날 수 있는 건강 피해에 대한 역학 연구의 정량적 근거를 제공하고 있다.

Citations

Citations to this article as recorded by  
  • Trends in mortality related to unintentional poisoning in the South Asian region from 1990 to 2019: analysis of data from the Global Burden of Disease Study
    Nadeem Ullah Khan, Uzma Khan, Umerdad Khudadad, Asrar Ali, Ahmed Raheem, Shahan Waheed, Junaid Abdul Razzak
    BMJ Open.2023; 13(2): e062744.     CrossRef
  • Prevalence of Carbon Monoxide Poisoning and Hyperbaric Oxygen Therapy in Korea: Analysis of National Claims Data in 2010–2019
    Eunah Han, Gina Yu, Hye Sun Lee, Goeun Park, Sung Phil Chung
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
  • Acute carbon monoxide poisoning in Shandong, China: an observational study
    Lina Zhang, Di Wu, Mingyue Xu, Yonghui Bian, Youcun Wang, Guangkai Gao, Qing Sun
    Chinese Medical Journal.2022; 135(13): 1539.     CrossRef
  • Development of delayed neurologic sequelae in acute carbon monoxide poisoning cases caused by briquette-based kotatsu
    Makoto Onodera, Yasuhiko Tsukada, Tsuyoshi Suzuki, Kotaro Sorimachi, Kenichi Ebihara, Lubna Sato, Rie Zenda, Satoshi Ueno, Kazuki Sugaya, Ken Iseki
    Medicine.2021; 100(16): e25009.     CrossRef
Risk factors contributing to the incidence and mortality of acute childhood poisoning in emergency department patients in Iran: a hospital-based case-control study
Hamideh Feiz Disfani, Mostafa Kamandi, Seyed Mohammad Mousavi, Sayyed Majid Sadrzadeh, Roohie Farzaneh, Najme Doolabi, Kazem Rahmani
Epidemiol Health. 2019;41:e2019016.   Published online April 23, 2019
DOI: https://doi.org/10.4178/epih.e2019016
  • 15,128 View
  • 241 Download
  • 15 Web of Science
  • 16 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Since poisoning is one of the most important preventable factors contributing to the hospitalization and death of children who present to emergency departments, this study was carried out to investigate the risk factors contributing to the incidence and mortality of acute childhood poisoning.
METHODS
This hospital-based case-control study included 243 cases and 489 controls, drawn from daily admissions to the emergency departments of the included hospitals according to the inclusion and exclusion criteria.
RESULTS
Gastrointestinal poisoning was the most common poisoning type, found in 87.7% of subjects, and medications were the most common cause of poisoning (49.8%). Multiple logistic regression analysis showed that a history of poisoning (odds ratio [OR], 10.44; 95% confidence interval [CI], 5.58 to 19.51; p<0.001) and the availability of poisonous substances (OR, 8.88; 95% CI, 5.41 to 14.56; p<0.001) were among the most important predictors of childhood poisoning. Respiratory poisoning (OR, 6.72; 95% CI, 1.40 to 32.07; p<0.05) and the presence of addiction in the family (OR, 4.54; 95% CI, 1.10 to 18.68; p<0.05) were the most important predictors of mortality among children with poisoning.
CONCLUSIONS
Addiction and the presence of physical or psychological disorders in family members, a history of poisoning, and the availability of poisonous substances were significantly associated with the incidence of childhood poisoning and resultant mortality.
Summary

Citations

Citations to this article as recorded by  
  • Clinical manifestation and laboratory data of illicit drugs versus other substances intoxication in children
    Leila Barati, Mohammadali Vakili, Omid Mehrpour, Mehrdad Teimoorian
    Scientific Reports.2025;[Epub]     CrossRef
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    Karoliny Brock, Gabriel Oscar Cremona Parma, Alessandra de Sá Soares, Fabiana Schuelter-Trevisol
    Revista Paulista de Pediatria.2024;[Epub]     CrossRef
  • Poisoning in children and adolescents in Kermanshah city, Iran
    Mitra Hemmati, Mohamad Reza Tohidi, Ali Mohammadi, Firozeh Jahanpour, Bahareh Andayeshgar, Sahar Fallah
    BMC Pediatrics.2024;[Epub]     CrossRef
  • Acute Poisoning Among Children Admitted to Alexandria Poison Center, Egypt: Patterns and Predisposing Factors
    Esraa Abd El-Aziz, Mohamed M Tahoun, Moustafa A Arafa, Asmaa S El-Banna
    Cureus.2024;[Epub]     CrossRef
  • Patterns and Outcomes of Acute Poisoning Among Children Presenting to Emergency Department in AlAhsa, Saudi Arabia
    Hussain A AlGhadeer, Raghad Y Alturaifi, Jinan A AlGhafli, Mohammed H Alshawker, Alla M AlBisher, Fatimah A AlGhadeer, Alla A Bokhamseen, Ahmed Y AlGhadeer, Abdullah F Al Muaibid, Hassan A Alhajji, Ahmed A Al Shams, Salman F Aldubayyan, Abdullah A Alkha
    Cureus.2024;[Epub]     CrossRef
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    Raziye Celen, Tuba Ozaydin, Alaaddin Yorulmaz
    Public Health Nursing.2023; 40(2): 250.     CrossRef
  • Initial clinical and laboratory parameters triaging non-pharmaceutical acute pediatric poisoned patients for potential adverse outcomes: a three-year retrospective study
    Ghada N El-Sarnagawy, Mona M Ghonem, Nadia E Helal
    Toxicology Research.2023;[Epub]     CrossRef
  • Knowledge, Attitude, and Practice of Nurses Toward the Initial Managements of Acute Poisoning in Public Hospitals of Bahir Dar City, Northwest Ethiopia 2022: Cross-Sectional Study
    Ousman Adal, Yigremew Hiamanot, Abdulkadir Zakir, Redeat Regassa, Asnake Gashaw
    SAGE Open Nursing.2023;[Epub]     CrossRef
  • Data Infrastructure for a Poisoning Registry with Designing Data Elements and a Minimum Data Set
    Azam Sabahi, Farkhondeh Asadi, Shahin Shadnia, Reza Rabiei, Azamossadat Hosseini
    Shiraz E-Medical Journal.2022;[Epub]     CrossRef
  • Fatal Outcome in Acutely Poisoned Children With Hospitalization
    Narges Gholami, Rebecca McDonald, Fariba Farnaghi, Maryam Hosseini Yazdi, Nasim Zamani, Hossein Hassanian-Moghaddam
    Pediatric Emergency Care.2022; 38(2): e659.     CrossRef
  • Poisoning-related emergency department visits: the experience of a Saudi high-volume toxicology center
    Mohammad Ali Alghafees, Abdullah Abdulmomen, Mahmoud Eid, Ghadah Ibrahim Alhussin, Mohammed Qasem Alosaimi, Ghadah Saad Alduhaimi, Mohammed Talal Albogami, Mohammed Alhelail
    Annals of Saudi Medicine.2022; 42(1): 36.     CrossRef
  • Características de los pacientes pediátricos que ingresan a terapia intensiva por intoxicaciones graves
    Lucina Gordillo-Rodríguez, Lucía Escobedo-Berumen, Mario Enrique Rendón-Macías, Diego Garay-Carmona, Andrés Blanco-Montero, Paloma Vizcarra-Alvarado, Isabel Bernárdez-Zapata, José Iglesias-Leboreiro
    Revista Mexicana de Pediatría.2022; 89(1): 12.     CrossRef
  • Evaluation of Clinical, Socioeconomic, and Demographic Factors in Different Poisoning Agents in Pediatric Population
    Noor Mohammad Noori, Tahereh Boryri, Alireza Teimouri, Sahar Safapour Moghadam
    International Journal of High Risk Behaviors and Addiction.2022;[Epub]     CrossRef
  • Toxicologic Exposures in California Emergency Departments in 2011 and Its Risk Factors
    Shahram Loftipour, Connie Au, Soheil Saadat, Tim Bruckner, Parvati Singh, Bharath Chakravarthy
    Western Journal of Emergency Medicine.2021; 22(5): 1139.     CrossRef
  • Characterization of Acute Poisoning in Hospitalized Children in Southwest China
    Zhu Li, Li Xiao, Lin Yang, Shaojun Li, Liping Tan
    Frontiers in Pediatrics.2021;[Epub]     CrossRef
  • Clinical profile of poisoning due to various poisons in children of age 0–12 years
    Diganta Saikia, RK Sharma, KoleV Janardhan
    Journal of Family Medicine and Primary Care.2020; 9(5): 2291.     CrossRef
Mortality from aluminum phosphide poisoning in Kermanshah Province, Iran: characteristics and predictive factors
Seyed Mohammad Navabi, Jafar Navabi, Abbas Aghaei, Zahra Shaahmadi, Ruhollah Heydari
Epidemiol Health. 2018;40:e2018022.   Published online May 27, 2018
DOI: https://doi.org/10.4178/epih.e2018022
  • 17,563 View
  • 277 Download
  • 22 Web of Science
  • 21 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Aluminum phosphide (ALP), also known in Iran as rice tablets, is one of the most effective rodenticides used to protect stored grain. However, ALP poisoning regularly causes mortality in humans. The aim of this study was to evaluate the characteristics and predictive factors of mortality from ALP poisoning.
METHODS
This study evaluated all patients with ALP poisoning referred to Imam Khomeini Hospital in Kermanshah Province, Iran from 2014 to 2015. For each patient, the following information was recorded: age, sex, the number of tablets consumed, the number of suicide attempts, the time elapsed from consumption to treatment, blood pressure, blood pH, HCO3 levels, and PCO2 . Differences between the survivors and non-survivors of ALP poisoning were analyzed using univariate logistic regression and multivariate analysis.
RESULTS
In this study, 48 patients were male and 29 patients were female (total: 77 patients). The average age of the survivors and non-survivors was 28.7 and 31.3 years, respectively. All cases (100%) of ALP poisoning were intentional, with the goal of committing suicide. The main predictive variables of mortality from ALP poisoning were blood pressure, blood pH, and time elapsed from consumption to treatment.
CONCLUSIONS
The likelihood of mortality in patients with ALP poisoning can be predicted using blood pressure, blood pH, and time elapsed from consumption to treatment. These findings may help healthcare providers take more effective measures to treat patients with ALP poisoning.
Summary

Citations

Citations to this article as recorded by  
  • Role of serum glucose/potassium ratio in assessing poisoning severity and adverse outcomes in patients with acute aluminum phosphide poisoning
    Ghada N. El-Sarnagawy, Amal S.A.F. Hafez, Mona M. Ghonem
    Toxicology Reports.2025; 14: 101947.     CrossRef
  • Shock and modified shock indices in predicting poisoning severity and outcomes in acute aluminum phosphide poisoned patients
    Mona M Ghonem, Amira A Abdelnoor, Aliaa A Hodeib
    Toxicology Research.2024;[Epub]     CrossRef
  • AN ASSESSMENT OF PESTICIDE POISONING INCIDENCES PRESENTED AT HEALTH CARE FACILITIES IN MASHONALAND CENTRAL PROVINCE, ZIMBABWE
    Kenneth Chipere, Claid Mujaju, Taurai Matyora, Shumirayi Muhera, Shengai Mwale, Peter Ishe Muzofa, Kudzai Kusena, Ivy Getrude Saunyama
    Journal of Experimental Biology and Agricultural Sciences.2024; 12(2): 226.     CrossRef
  • Metal phosphide poisoning in a disaster‐stricken area. Can early hemodialysis improve outcomes?
    Najjar Abdo, Sekkarie Mohamed, Valerie Luyckx, Alabdullah Mohammad, Sulaiman Abdu el Rahman, Kuhn Christine, Jetter Alexander, Hajj Nasan Khaled, Murad Lina, Rifai Ahmad Oussama, Sami Alasfar, AlhajHusain Ahmad
    Hemodialysis International.2024; 28(3): 351.     CrossRef
  • Survival after aluminum phosphide poisoning with cardiotoxicity: a case report
    Habtamu Mesele Gebray, Addisu Liknaw Chekol
    Journal of Medical Case Reports.2024;[Epub]     CrossRef
  • The performance of ejection fraction as a predictor of mortality and morbidity in acute aluminium phosphide poisoning
    Meray Medhat Shokry Zaghary, Hasnaa Ahmed Ahmed Ali, Asmaa Mohammed Khalaf Ahmed
    Toxicology Research.2024;[Epub]     CrossRef
  • Prognostic significance of poison-related factors and consumption patterns in acute aluminum phosphide poisoning
    Lokhesh Chockalingam Anbalagan, Ashok Kumar Pannu, Ashish Bhalla, Deba Prasad Dhibar, Navneet Sharma
    Turkish Journal of Emergency Medicine.2023; 23(2): 88.     CrossRef
  • Comparing the effectiveness of L-carnitine and paraffin oil in acute aluminum phosphide poisoning using predictive biomarkers and scores: A randomized controlled clinical trial
    Walaa G Abdelhamid, Mahmoud L Sakr, Olfat E Mostafa, Dalia Zaafar, Hanan M Abdelwahab
    Human & Experimental Toxicology.2023;[Epub]     CrossRef
  • Prognostic significance of poison-related factors and consumption patterns in acute aluminum phosphide poisoning
    LokheshChockalingam Anbalagan, AshokKumar Pannu, Ashish Bhalla, DebaPrasad Dhibar, Navneet Sharma
    Turkish Journal of Emergency Medicine.2023;[Epub]     CrossRef
  • Aluminum Phosphide Poisoning in the North of Iran: A Register-based Research
    Hamid Mohammadi Kojidi, Mirsaeed Attarchi, Morteza Rahbar-Taramsari, Alireza Badsar, Niloofar Faraji, Yalda Rastak, Hadi Sedigh Ebrahim-Saraie
    Current Drug Safety.2023; 18(3): 323.     CrossRef
  • The therapeutic effect of a novel parenteral formulation of dihydroxyacetone in aluminum phosphide-intoxicated patients
    Hossein Niknahad, Reza Heidari, Ali Jangjou, Vahidreza Asghari, Fatemeh M. Niknahad, Fazel Goudarzi, Nasim Tavakoli, Mitra Rahimi, Amir Mohammad Niknahad, Marziye Rashedinia
    Heliyon.2023; 9(11): e22165.     CrossRef
  • Toxicoepidemiology of Phosphide Poisoning in the Central Part of Iran
    Nastaran Eizadi-Mood, Mahnaz Momenzadeh, Masoumeh Sadeghi, Ahmad Yaraghi, Ali Mohammad Sabzghabaee, Sam Alfred
    Journal of Research in Pharmacy Practice.2023; 12(1): 21.     CrossRef
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    A K Pannu, L Jhuria, A Bhalla, N Sharma
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  • Pattern of Suicide Methods and Postmortem Toxicological Findings in Suicide-Related Deaths
    Rooholah Valipour, Ahmad Shekari, Mehrdad Setareh, Kambiz Soltaninejad
    American Journal of Forensic Medicine & Pathology.2021; 42(1): 23.     CrossRef
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    Dereje Endeshaw Bogale Bogale, Birtukan Demilew Ejigu, Tsigereda Amsalu Muche
    Open Access Emergency Medicine.2021; Volume 13: 239.     CrossRef
  • Suicide by poisoning in Pakistan: review of regional trends, toxicity and management of commonly used agents in the past three decades
    Maria Safdar, Khalid Imran Afzal, Zoe Smith, Filza Ali, Pervaiz Zarif, Zahid Farooq Baig
    BJPsych Open.2021;[Epub]     CrossRef
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    Victoriia E. Kutai, Vasiliy Yu. Tsygankov
    Medical academic journal.2021; 21(2): 25.     CrossRef
  • Cardioprotective activity of ethanolic extract of Echinophora cinerea against aluminum phosphide poisoning in rats
    Sara Haydari, Afshin Nazari, Maryam Moghimian, Mehrnoosh Sedighi, Saber Ghaderpour
    Journal of Food Biochemistry.2020;[Epub]     CrossRef
  • Effect of aluminium phosphide (ALP) gas inhalation exposure on adipose tissue characteristics and histological toxicity in male rats
    Zoya Tahergorabi, Mahmoud Zardast, Ali Naghizadeh, Borhan Mansouri, Iman Nakhaei, Mohsen Zangouei
    Journal of Taibah University for Science.2020; 14(1): 1317.     CrossRef
  • Cardiogenic Shock Due to Aluminum Phosphide Poisoning Treated with Intra-aortic Balloon Pump: A Report of Two Cases
    Omid Mehrpour, Sadegh Asadi, Mohammad Ali Yaghoubi, Nahid Azdaki, Nastaran Mahmoodabadi, SeyedYoosef Javadmoosavi
    Cardiovascular Toxicology.2019; 19(5): 474.     CrossRef
  • Antidotal Action of Some Gold(I) Complexes toward Phosphine Toxicity
    Kimberly K. Garrett, Kristin L. Frawley, Samantha Carpenter Totoni, Yookyung Bae, Jim Peterson, Linda L. Pearce
    Chemical Research in Toxicology.2019; 32(6): 1310.     CrossRef
Epidemiology and risk factors of voluntary pesticide poisoning in Morocco (2008-2014)
Zineb Nabih, Latifa Amiar, Zakaria Abidli, Maria Windy, Abdelmajid Soulaymani, Abdelrhani Mokhtari, Rachida Soulaymani-Bencheikh
Epidemiol Health. 2017;39:e2017040.   Published online September 1, 2017
DOI: https://doi.org/10.4178/epih.e2017040
  • 16,945 View
  • 278 Download
  • 9 Web of Science
  • 12 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
To determine the epidemiological profile and risk factors of voluntary poisoning by pesticides.
METHODS
A retrospective analysis was conducted of all cases of voluntary poisoning by pesticides registered at the AntiPoison and Pharmacovigilance Center of Morocco between January 2008 and December 2014.
RESULTS
During the study period, 2,690 cases of acute pesticide poisoning were registered. The region of Rabat-Salé-Zemmour-Zaer accounted for the largest proportion, with 598 cases. The average age of the patients was 24.63±10.29 years. The sex ratio (female-to-male) was 0.45. Adults and teenagers were most affected by this type of poisoning, with 1,667 cases (62.0%) and 806 cases (30.0%), respectively. Suicide attempts accounted for 98.4% of the cases (2,469 cases). Pesticide poisoning occurred more often in urban zones (64.8%). Insecticides were incriminated in 14.0% of cases, with a mortality rate of 4.2%. Among the 1,635 patients for whom the outcomes were known, 154 died, corresponding to a mortality rate of 5.7%.
CONCLUSIONS
Voluntary intoxication by pesticides presents a real scourge that affects public health, and in this study, we developed an epidemiological profile of this phenomenon. Nevertheless, this study has limitations in that it did not evaluate the impact of the socioeconomic and psychological factors that are important contributors to this type of poisoning.
Summary

Citations

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  • Intoxications graves : état des lieux au service des urgences de l’hôpital du CHU Ibn Rochd
    Berdai Ghizlane, Moussaoui Mohammed, Rahmoune Imane, Adounai Bader, Mouhaoui Mohammed, Filali Houda
    Toxicologie Analytique et Clinique.2025;[Epub]     CrossRef
  • Situation Analysis of Suicide and Self-Harm in the WHO Eastern Mediterranean Region
    Annette Erlangsen, Murad Khan, Wen Su, Khawlah Alateeq, Fatma Charfi, Trine Madsen, Ping Qin, Britt Reuter Morthorst, Morten Thomsen, Aiysha Malik, Piumee Bandara, Alexandra Fleischmann, Khalid Saeed
    Archives of Suicide Research.2024; 28(3): 760.     CrossRef
  • Central Venous Catheter Complications in the Poisoning Emergency Center: A 5-Year Cross-Sectional Study
    Amirmohammad Bavandipour, Masumeh Safaee, Mohammad Javad Tarrahi, Nastaran Eizadi-Mood
    Advanced Biomedical Research.2024;[Epub]     CrossRef
  • Exposure of children to glyphosate in Morocco: Urinary levels and predictors of exposure
    Imane Berni, Aziza Menouni, Matteo Creta, Ibrahim El Ghazi, Radu-Corneliu Duca, Lode Godderis, Samir El Jaafari
    Environmental Research.2023; 217: 114868.     CrossRef
  • Acute pesticide poisoning in the central part of Iran: A 4-year cross-sectional study
    Nastaran Eizadi-Mood, Razieh Mahvari, Mahsa Akafzadeh Savari, Ehsan Mohammadbeigi, Awat Feizi, Parisa Mirmoghtadaei, Ramin Sami, Rokhsareh Meamar
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    Lai Fong Chan, Song Jie Chin, Tsui Huei Loo, Ravivarma Rao Panirselvam, Shu-Sen Chang, Hwei Yuen Chang, Anissa Raudhah Mokhzani, Farynna Hana Ab Rahman, Leah Utyasheva, Michael Eddleston
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    Fitria Saftarina, Jamsari Jamsari, Masrul Masrul, Yuniar Lestari
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    Achbani Abderrahmane, Ahmed Kharbach, Hajar Azzine, Abdelmajid Lkoul, Youssef Bouchriti, Zakariae Cherrat, Nadia Ezzahir, Mohamed Boukrim, Hasnaa Sine
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  • Características sociodemográficas y clínicas relacionadas con la condición final de pacientes intoxicados por paraquat en un hospital del suroccidente de Colombia
    Yalila Andrea Ordóñez-Zarama, Daniel Jurado-Fajardo, María Camila Paredes-Panesso, David Alejandro Rosero-Bello, Franco Andrés Montenegro-Coral, José Alirio Risueño-Blanco
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    Edgar Remberto Quinteros Martinez, José Alejandro López Vásquez
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Estimation of the rate and number of underreported deliberate self-poisoning attempts in western Iran in 2015
Mehdi Moradinazar, Farid Najafi, Mohammad Reza Baneshi, Ali Akbar Haghdoost
Epidemiol Health. 2017;39:e2017023.   Published online June 15, 2017
DOI: https://doi.org/10.4178/epih.e2017023
  • 16,197 View
  • 173 Download
  • 6 Web of Science
  • 5 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Rates of attempted deliberate self-poisoning (DSP) are subject to undercounting, underreporting, and denial of the suicide attempt. In this study, we estimated the rate of underreported DSP, which is the most common method of attempted suicide in Iran.
METHODS
We estimated the rate and number of unaccounted individuals who attempted DSP in western Iran in 2015 using a truncated count model. In this method, the number of people who attempted DSP but were not referred to any health care centers, n<sub>0</sub> , was calculated through integrating hospital and forensic data. The crude and age-adjusted rates of attempted DSP were estimated directly using the average population size of the city of Kermanshah and the World Health Organization (WHO) world standard population with and without accounting for underreporting. The Monte Carlo method was used to determine the confidence level.
RESULTS
The recorded number of people who attempted DSP was estimated by different methods to be in the range of 46.6 to 53.2% of the actual number of individuals who attempted DSP. The rate of underreported cases was higher among women than men and decreased as age increased. The rate of underreported cases decreased as the potency and intensity of toxic factors increased. The highest underreporting rates of 69.9, 51.2, and 21.5% were observed when oil and detergents (International Classification of Diseases, 10th revision [ICD-10] code: X66), medications (ICD-10 code: X60-X64), and agricultural toxins (ICD-10 codes: X68, X69) were used for poisoning, respectively. Crude rates, with and without accounting for underreporting, were estimated by the mixture method as 167.5 per 100,000 persons and 331.7 per 100,000 persons, respectively, which decreased to 129.8 per 100,000 persons and 253.1 per 100,000 persons after adjusting for age on the basis of the WHO world standard population.
CONCLUSIONS
Nearly half of individuals who attempted DSP were not referred to a hospital for treatment or denied the suicide attempt for political or sociocultural reasons. Individuals with no access to counseling services are at a higher risk for repeated suicide attempts and fatal suicides.
Summary

Citations

Citations to this article as recorded by  
  • A validated dilute-and-shoot LC–MS-MS urine screening for the analysis of 95 illicit drugs and medicines: Insights from clinical and forensic Brazilian cases
    Bruno Pereira Dos Santos, Letícia Birk, Patrícia Schwarz, Viviane Cristina Sebben, Ângela Malysz Sgaravatti, Giovanna Cristiano de Gouveia, Adriana Ubirajara Silva Petry, Francisco Paz de Menezes, Alexsandro Pinto Gonzaga, Paula Flores Schlickmann, Marcel
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An Epidemiological Investigation on an Outbreak of Bacillus Cereus Food Poisoning in a Girls' High School in Sangju-si, Korea, 2008.
Hyun Dong Lee, Sun Ok Lee, Hyun Sul Lim, Kyoung Chan Lee, Kyu Jin Chang, Young A Kang
Korean J Epidemiol. 2008;30(2):168-177.   Published online December 31, 2008
DOI: https://doi.org/10.4178/kje.2008.30.2.168
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AbstractAbstract PDF
Abstract
PURPOSE
In May 2008, a diarrhea outbreak occurred among students of in a girls' high school (S school) in Sangju-si, Korea. An epidemiological investigation was carried out to clarify the cause and transmission route of the outbreak.
METHODS
S school has been providing meals directly since July 2007. We conducted a questionnaire survey among 591 persons, and examined 283 rectal swabs and 98 environmental specimens. The patient case was defined as a member of S school who had diarrhea more than one time in a day, accompanied with one or more symptoms among abdominal pain or tenesmus from May 19th to May 26th 2008.
RESULTS
The attack rate was 24.0%. Bacillus cereus were cultured from three of the rectal swabs and five of the preserved foods. It was suspicious that contamination was possible in seasoning vegetables, and we found some foods were seasoned with spices after being cooled by moving cooler for about 20 minutes. Enterotoxin positive B. cereus were cultured from two foods cooled by moving cooler. Enterotoxin negative B. cereus were cultured from two environmental specimens of the moving cooler.
CONCLUSIONS
We presumed the cause of the diarrhea outbreak in S school was food poisoning by B. cereus. Because enterotoxin positive B. cereus were cultured from rectal swabs and foods, and the symptoms were corresponded. We estimated the outbreak was occurred by this process that B. cereus in the moving cooler contaminated foods during cooling and then rapidly proliferated.
Summary

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Prevalence and Risk Factors of Green Tobacco Sickness among Korean Tobacco Harvesters, 2003.
Kwan Lee, Hyun Sul Lim
Korean J Epidemiol. 2005;27(1):129-139.
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AbstractAbstract PDF
Abstract
OBJECTIVES
This study was carried out to understand the prevalence and risk factors of green tobacco sickness (GTS) among Korean tobacco harvesters.
METHODS
The authors conducted a questionnaire among the tobacco harvesters (842 persons from 449 out of 500 tobacco harvesting households) in Cheongsong-gun for 4 days from Sep 1 to 4, 2003.
RESULTS
The study subjects contained 440 males and 402 females. The prevalence of GTS in 2003 was 39.2%, and was significantly higher in females (53.4%) than in males (25.6%, p<0.01). The incidence density of GTS according to the number of workdays in 2003 was 11.5 spells/100 person-days. The GTS symptoms reported by the tobacco harvesters in 2003 were nausea in 320 cases (97.0%), dizziness in 311 cases (94.2%), headache in 264 cases (80.0%) and vomiting in 209 cases (63.3%) etc. Through multiple logistic regression, the factors significantly associated with GTS were found. Odds ratio for smoking, age over sixty(compared with under forties), and working over 10 hours(compared with under 10 hours) were respectively 0.23 (95% CI: 0.16~0.33), 0.46 (95% CI: 0.23~0.93), and 1.53 (95% CI: 1.12~2.10).
CONCLUSIONS
Our studies before this, there were significant recall bias by time lag between harvesting period and survey time. We tried to study promptly after harvesting tobacco leaves to solve this recall bias. More extensive epidemiologic studies, and educations for harvesters are expected.
Summary
Epidemiological Characteristics and Changes of Prevalence for Green Tobacco Sickness among Korean Tobacco Harvesters.
Joo Sub Lee, Sung Han Bae, Hyun Sul Lim, Kwan Lee
Korean J Epidemiol. 2004;26(1):39-49.
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AbstractAbstract PDF
Abstract
PURPOSE
This study was carried out to investigate the epidemiological characteristics and changes of prevalence for green tobacco sickness (GTS) for 2 years.
METHODS
The author conducted a questionnaire survey on the tobacco harvesters (875 persons from 478 out of 555 tobacco harvesting households surveyed last year) in Cheongsong-gun for 4 days from May 26 to 29, 2003.
RESULTS
The study subjects comprised 456 males and 419 females. The prevalence of GTS in 2002 was 50.5%, which was significantly higher than the 43.0% in 2001 (p<0.01). The incidence density of GTS in 2002 was 11.3 spells/100 person?working-days, which was lower than the 12.1 spells in 2001. Regardless of risk factors such as smoking, workingdays, and working hours, the prevalence of GTS in 2002 was higher than that in 2001. Among various GTS symptoms reported by the tobacco harvesters in 2002, cases of nausea were increased, while diarrhea, dyspnea and cough were decreased compared with 2001. The degree of GTS symptoms in 2002 was increased in 198 cases (64.5%), and decreased in 42 cases (13.7%). The proportion of harvesters who underwent treatment from their local medical facilities in 2002 was significantly decreased compared with that in 2001.
CONCLUSIONS
In Korea, there are many tobacco-harvesting households, most of which may be stricken with GTS. It is very important for doctors to diagnose the disease exactly and to develop prevention methods for GTS. I expect that more extensive epidemiological studies including the incidence and associated risk factors will be needed. In addition, surveillance system and measurements of urinary cotinine should be conducted.
Summary
An Epidemic Survey for Salmonellosis Occurred on a Baby's First Birthday Banquet in Jeju Island.
Sang Yeop Shin, Jung Yun Hong, Jong Myon Bae
Korean J Epidemiol. 2004;26(1):27-38.
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AbstractAbstract PDF
Abstract
OBJECTIVES
A field investigation was done to identify the level of epidemic and to evaluate the infection route of Salmonellosis occurred in a baby's first birthday banquet in Jeju Island.
METHODS
Among participants in the banquet given on a baby's first birthday, persons showing gastrointestinal symptoms were conducted by the structured questionnaire and stool culture. The symptomless persons were also surveyed by self-responded structured questionnaire. The causal relationship between food items and gastrointestinal symptoms was proved by odds ratio and Wilcoxon rank-sum test.
RESULTS
Salmonella london was identified in the stools of 12 subjects among 20 participants showing gastrointestinal symptoms, as well as in the boiled pork hock.
CONCLUSIONS
This outbreak event is thought to happen after participants took the boiled pork hock that contaminated with S almonella london during the storage process.
Summary
Green Tobacco Sickness on Tobacco Harvesters in a Korean Village.
Hyun Sul Lim, Kwan Lee
Korean J Epidemiol. 2002;24(1):29-36.
  • 6,680 View
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AbstractAbstract PDF
Abstract
PURPOSE
This study was conducted to understand the proportion and the risk factors of green tobacco sickness (GTS).
METHODS
The authors conducted a questionnaire among tobacco harvesters; 94 people from 59 households at a village in Youngduk-gun from Feb 1 to Feb 3, 2002.
RESULTS
The study group contained 49 females and 45 males. The mean durations of employment and the length of the working day were 23.3 14.2 years and 11.8 2.7 hours, respectively. The symptoms related to tobacco harvest were dizziness in 64 cases (68.1%), headache in 46 cases (48.9%), nausea in 45 cases (47.9%), sore eyes in 37 cases (39.4%), and vomiting in 36 cases (38.3%). The experience of GTS up until 2001 was 70.2%. The proportion of GTS in 2001 was 67.0% and was significantly higher in females (84.9%, p<0.01). The proportion of GTS by work days in 2001 was 16.4 spells/100 person days. The proportion of non-smokers was significantly higher than smokers (p<0.01). Therefore, smoking was negatively associated with GTS. The use of gloves and wristlets significantly increased the proportion of GTS (p<0.05). Through multiple logistic regression, significantly associated factors with GTS were found to be smoking (OR=0.18, 95% CI: 0.06-0.54), wearing of gloves (OR=9.20, 95% CI: 1.27-66.52), and sweating (OR= 3.52, 95% CI: 1.08-11.47). Of those who reported GTS in 2001, 65.6% underwent treatment from the local medical facilities. The distribution of the medical facilities utilized was pharmacies 39.3%, and medical health centers 26.2%.
CONCLUSIONS
: In Korea, there are many tobacco harvesters, and most may be stricken with green tobacco sickness. In the future it is hoped that more extensive epidemiological studies will be conducted
Summary
Epidemiol Health : Epidemiology and Health
© Korean Society of Epidemiology.
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